Association between Obesity and Neighborhood Socioeconomic Status in Korean Adolescents Based on the 2013 Korea Youth Risk Behavior Web-Based Survey

Early life malnutrition and risk of T2DM adulthood: evidence from the lower socioeconomic status of northwest Chinese population

Objective

This study aimed to explore whether famine exposure during early life are associated with a high risk of Type 2 Diabetes Mellitus (T2DM) in adulthood and the role of socioeconomic status (SES) on this effect.

Materials and methods

We conducted a secondary data analysis based on data from a cross-sectional survey, collected 3,355 participants born between January 1, 1941 and December 31, 1966. Participants were categorized into four groups based on their date of birth, unexposed (individuals born in 1963-1966), infant exposed (individuals born in 1959-1962), childhood exposed (individuals born in 1949-1958), and adolescent exposed (born in 1941-1948). The association of famine exposure with T2DM risk in adults and conducted separately in plain area and mountain area was assessed using logistics regression model.

Result

22.35% of participants were diagnosed with T2DM, of which 43.47% were from the childhood famine-exposed group, representing the highest proportion among all subgroups (p < 0.001). Participants exposed to famine during childhood and adolescence from the lower SES mountain areas showed a significantly higher prevalence of T2DM in adulthood than those from the plain areas (p < 0.001). The adolescence stage exposed famine will increase the risk of T2DM in the mountain area (OR 2.46, 95% CI 1.61, 3.77).

Conclusion

No strong evidence demonstrates that exposure to famine during the early life stage increases the risk of developing T2DM in adulthood. However, populations with lower SES are likely to be exposed to more risk factors for T2DM.

Poor sleep is associated with energy drinks consumption among Korean adolescents

OBJECTIVE

A growing number of Korean adolescents consume energy drinks, which may increase the risk of obesity, anxiety and insomnia. We examined whether poor sleep was associated with energy drink consumption among study participants.

DESIGN

We used a cross-sectional design.

SETTING

The Korea Youth Risk Behavior Web-Based Survey data from 2019.

PARTICIPANTS

To determine the association between sleep and energy drink consumption, we compared the independent variables for 50,455 adolescents in Korea (aged 14-19 years) using multivariate logistic regression and sensitivity analyses.

RESULTS

In Korea, 69·5 % adolescents consumed energy drinks, 17·1 % slept for less than 5 h, 22·4 % slept for 5-6 h, 23·8 % slept for 6-7 h, 19·9 % slept for 7-8 h and 16·7 % slept for 8 h or more. Regarding sleep satisfaction, 21·0 % reported sufficient, 32·6 % reported just enough and 46·5 % reported insufficient. Regarding sleep duration, it was found that less than 5 h (OR, 2·36; 95 % CI (2·14, 2·60)) and lower sleep satisfaction (OR, 1·12; 95 % CI (1·03, 1·21)) were highly associated with energy drink consumption, with statistical significance at P < 0·05. Adolescents with lower sleep duration (adjusted OR (aOR), 6·37; 95 % CI (4·72, 8·61)) and a lack of sleep satisfaction (aOR, 1·44; 95 % CI (1·16, 1·78)) reported drinking a high amount of energy drinks, that is, at least once a day.

CONCLUSION

In addition to efforts to decrease the amount of energy drinks consumed, sleep hygiene education needs to be strengthened.

Prostate Cancer Screening in Middle-Aged and Older American Men: Combined Effects of Ethnicity and Years of Schooling

BACKGROUND

Prostate cancer screening is more commonly utilized by highly educated people. As shown by marginalization-related diminished returns (MDRs), the effects of socioeconomic status (SES) such as education on the health outcomes are considerably smaller for ethnic minorities than for Whites. The role of MDRs as a source of ethnic health disparities is, however, still unknown.

OBJECTIVES

The current study had two aims: first, to explore the association between years of schooling and having taken a prostate-specific antigen (PSA) test among men in the US, and second, to explore ethnic differences in this association.

METHODS

This study was a secondary analysis of data from the National Health Interview Survey (NHIS-2015). The data of 5,053 men aged 55 years or older who were either Latino, non-Latino, African-American, or White were analyzed. Years of schooling was the independent variable. The dependent variable was taking a PSA test sometime during one's lifetime. Age, region, and employment were the control variables. Ethnicity was the focal moderating variable. Binary logistic regression was used for data analysis.

RESULTS

A higher number of years of schooling was associated with higher odds of having taken a PSA test, net of all confounders. Ethnicity showed a significant statistical interaction with years of schooling on having taken a PSA test. This interaction was suggestive of a smaller slope for Latino men than non-Latino men. White and African American men did not show differential effects of years of schooling on having taken a PSA test.

CONCLUSION

Similar to the MDRs patterns in other domains, non-Latino White men show more health gain from their years of schooling than Latino men. Highly educated Latino men still need programs to encourage their use of prostate cancer screening.

Combined Effects of Race and Educational Attainment on Physician Visits Over 24 Years in a National Sample of Middle-Aged and Older Americans

Background

The literature on Minorities' Diminished Returns (MDRs) have shown worse than expected health of the members of racial and ethnic minority groups particularly Blacks. Theoretically, this effect can be in part due to weaker effects of educational attainment on preventive care and disease management in highly educated racial and ethnic minorities.

Objectives

The current study explored the racial and ethnic differences in the effect of baseline educational attainment on % adherance to the routine physician visits among middle-aged and older adults in the US.

Methods

This is a prospective study with 24 years of follow up. The Health and Retirement Study (HRS: 1992-2016) included 10 880 middle-aged and older adults who were Hispanic, non-Hispanic, Black or White. The independent variable was educational attainment. The dependent variable was adherance to the routine physician visits (%). Age, gender, marital status, income, health behaviors (smoking and drinking) and health (depression, self-rated health, and chronic diseases) were the covariates. Race and ethnicity were the focal moderators. Linear regression was used for data analysis.

Results

Overall, higher educational attainment was associated with higher % of adherance to the routine physician visits over the course of follow-up, net of all confounders. Race showed a significant statistical interaction with educational attainment suggesting of a smaller effect of high education attainment on % adherance to the routine physician visits for Black than White middle-aged and older adults. A similar interaction could not be found for the comparison of Hispanic and non-Hispanic middle-aged and older adults.

Conclusion

Educational attainment is associated with a larger increase in preventive and disease management doctor visits for White than Black middle-aged and older adults. This is a missed opportunity to improve the health of highly educated middle-aged and older adults. It is not race/ethnicity or class that shapes health behaviors but race/ethnicity and class that shape people's pro-health behaviors. At least some of the racial health disparities is not due to low SES but diminished returns of SES.

Educational Attainment Better Increases the Chance of Breast Physical Exam for Non-Hispanic Than Hispanic American Women: National Health Interview Survey

Background

The Minorities' Diminished Returns (MDRs) theory suggests that the health effect of educational attainment is considerably smaller for members of racial and ethnic minority groups than for Whites.

Objective

The current study explored the racial and ethnic differences in the association between educational attainment and breast physical exam (BPE) among women in the U.S.

Methods

The National Health Interview Survey (NHIS 2015) included 12 510 women who were Hispanic or non-Hispanic Black or White people. The independent variable was the level of educational attainment. The dependent variable was lifetime BPE. Age, region, marital status, and employment were the covariates. Race and ethnicity were the focal moderators. Logistic regressions were used for data analysis.

Results

Overall, higher educational attainment was associated with higher odds of BPE, net of all confounders (odds ratio [OR] = 1.11, 95% CI = 1.09-1.13). Ethnicity showed a significant statistical interaction with educational attainment on BPE (OR = 0.96, 95% CI = 0.93-1.00), which was suggestive of a smaller effect of high education attainment on BPE for Hispanic than non-Hispanic women. The same interaction could not be found for the comparison of White and Black women (OR = 0.98, 95% CI =0.94-1.02).

Conclusion

In line with other domains, non-Hispanic White women show a larger amount of health gain from their educational attainment than Hispanic women. It is not ethnicity or class but ethnicity and class that shapes how people engage in pro-health behaviors. This result may help hospitals and healthcare systems to better reduce health disparities in their target populations.

Educational Attainment and Exercise Frequency in American Women; Blacks' Diminished Returns

BACKGROUND

Minorities' Diminished Returns (MDRs) refer to smaller protects health effects of socioeconomic status (SES) indicators for Blacks and other minority groups than Whites.

OBJECTIVES

The current study aimed to explore Black- White differences in the association between educational attainment and exercise frequency among women in the US.

METHODS

For the current study, we used the National Survey of American Life's (NSAL) data which included 3,175 women who were either White (n = 876) or Black (n = 2,299). The independent variable was educational attainment. The dependent variable was exercise frequency. Age, region, household income, financial distress, marital status, unemployment, and depression were the covariates. Race was the focal moderator. Linear regression was applied for data analysis.

RESULTS

In the overall sample of women, high educational attainment was associated with higher exercise frequency (b = 0.07, 95% CI = 0.02-0.12). Race and educational attainment showed a significant interaction (b = -0.09, 95% CI = -0.19-0.00), suggestive of a smaller effect of education attainment on exercise frequency for Black women than White women. In race specific models, high educational attainment was associated with higher exercise frequency for White (b = 0.12, 95% CI =0.04-0.20) but not Black (b = 0.03, 95% CI = -0.03-0.08) women.

CONCLUSION

In line with the past research on MDRs, White women gain more health from their educational attainment than Black women. It is not race or class but race and class that shape the health behaviors of American women.